Clindamycin vasculitis in patients with peripheral arterial vascular disease

Clindamycin was first synthesized in 1966. It is a chemical derivative of lincomycin with activity against aerobic gram-positive and gram-negative bacteria. The side effects include diarrhea, pseudomembranous colitis, metallic taste in the mouth, transient elevation of transaminases, granulocytopenia, thrombocytopenia, and rash. The incidence of maculopapular rashes has been reported to be approximately 10%. Leukocytoclastic angitis or vasculitis induced by clindamycin has been reported (Lambert et al., Cutis 30:615–619, 1982) and this is a very serious complication in patients with peripheral arterial vascular diseases which may leads to severe and deep necrotizing vasculitis. We report two cases of necrotizing vasculitis due to clindamycin which was used for the treatment of chronic wounds in patients suffering of peripheral vascular disease.